Stafford, Dale D

Stafford, Dale D is an individual health care provider with primary practice located at 130 Fisher Rd , Berlin VT 05602-9516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Stafford, Dale D can be contacted via phone (802) 225-7000.

Contact Information

Primary practice address
130 Fisher Rd Berlin VT 05602-9516
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 420006939 Vermont

Profile Details

NPI number 1619991494
LBN Legal business name Stafford, Dale D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jul 29th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619991494 NPPES
New York MEDICAID 01777706
New York MEDICAID 0005471

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